The Cribsiders S5 Ep96: Saltshakers and Stethoscopes: A Practical Approach to Hyponatremia
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Oct 25, 2023 Renowned pediatric nephrologist, Michelle Starr, provides valuable insights into the diagnosis and treatment of pediatric hyponatremia. She discusses the importance of water in hyponatremia, evaluating volume status for hyponatremia, and the complications of overcorrecting hyponatremia in pediatric patients.
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Hyponatremia is About Water Balance
- Hyponatremia fundamentally reflects an abnormal water balance relative to sodium in the body.
- Understanding serum osmolality and tonicity is key to appropriately diagnosing hyponatremia.
Confirm True Hyponatremia First
- Always confirm whether hyponatremia is true by checking serum osmolality alongside repeated serum sodium.
- This distinction prevents misdiagnosis from lab errors or pseudohyponatremia.
Urine Osmolality Reveals ADH Status
- Urine osmolality reflects ADH activity: low urine osmolality means ADH off, high means ADH on.
- This helps differentiate causes of hyponatremia based on kidney response.